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How to Safely Return to Running after Physical Therapy

How to Safely Return to Running after Physical Therapy

by Matthew Klayman, PT, DPT, OCS, Cert. DNLeave a Comment

Congratulations! You graduated from physical therapy! Although you may have gone there feeling injured, you are now slowly returning to your normal, active self. As you finish your sessions, it is important to get clearance on returning to running. Your physical therapist can help you determine a realistic running goal to make sure the two of you are on the same page.

Post-Injury Considerations

By the time you finish PT, you should be pain-free when leisurely walking and performing lower-level activities such as biking. However, as we all know, running is a different beast. Whether you sprained your ankle or had major knee surgery, there is usually confusion and worry when getting back to your old running self. You are likely asking yourself questions like, “Am I able to return to running my normal speed or mileage?” “Will I always have to keep up with my exercises?” and “Will I constantly be thinking and worrying about my injury?”

Unfortunately, you won’t feel like your normal self after that first run. Our bodies are amazing at healing, but at the same time, our tissues need time to adapt to load and stress. Just like shoes take time to wear in, our lower extremities need to be exposed to the rigors of forces coming up from the ground when we strike our foot while running. Although impact is felt with walking, it is significantly greater with running. Graded exposure to running forces allow our muscles and our brain time to adapt to the demands of the surface we are running under and determine what our body can handle at the present time.

Tips to Return to Running, Strong

As you begin to test the waters with a return to running, there are a few considerations that will keep you safe and healthy:

  • Keep up with your exercises: They were given to you to stay strong and mobile. Strengthening your glutes, lateral hips and quads can go a long way with helping to run more efficiently.
  • Stay on one surface: As you ramp up mileage, stay on soft or even surfaces. Try to avoid downhill or unstable surfaces to avoid unnecessary stressors.
  • Use plyometrics or jump training: This will get your legs used to higher amounts of steps and will help you dissipate load and forces from the ground more efficiently.
  • Attempt a run-walk method to build up your mileage: Do not increase your weekly mileage by more than 10% in order to help gradually expose your muscles to stress and avoid further overuse injuries.
  • Keep your stride rate up: Work on shortening your stride by increasing your step cadence. This will lead to a higher step count but with a decreased load through your lower body.2

Listen to Your Body

As you embark on your running recovery, know that getting back in the swing of things will have its challenges. Keep in mind that general muscle soreness is normal within 24-48 hours of a run and stiffness should dissipate shortly after you start moving. If soreness turns painful and lasts for longer than 48 hours, chances are you over did it. Take notice if you are becoming aware of a change in your stride; this can lead to compensatory patterns which will stress the muscles in ways they did not expect. If this persists, consult with your physical therapist.

Use Your Physical Therapy Knowledge

Coming back to running following an injury has its inherent challenges. Chances are it will not be a linear progression, and you should prepare for some peaks and valleys. Always remember the tools you have at your disposal to help you on this journey. Use your physical therapy exercises to reduce pain, improve strength, and improve mobility, and keep in mind that your PT is there for you even after you are discharged. We always have your back (and your running legs too)! Should you experience pain or injury when running, schedule a Free Assessment with our endurance experts. Free assessments are available in-clinic and virtually through our Telehealth platform.

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The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

1. “Step Length and Grade Effects on Energy Absorption and Impact Attenuation in Running.” Taylor & Francis,
2. Heiderscheit, Bryan C, et al. “Effects of Step Rate Manipulation on Joint Mechanics during Running.” Medicine and Science in Sports and Exercise, U.S. National Library of Medi-cine, Feb. 2011,

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Matthew Klayman was a physical therapist at Athletico Physical Therapy at the time of this blog.

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